{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:03:05Z","timestamp":1789948985345,"version":"4.0.1"},"reference-count":33,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Corticosteroids are sometimes administered to patients with severe brain edema associated with brain abscess. However, no studies have used methods that appropriately account for time\u2010varying covariates and immortal time to evaluate the impact of intravenous corticosteroid use on in\u2010hospital mortality. Therefore, we aimed to address these limitations and estimate the impact on in\u2010hospital mortality using a target trial emulation framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We identified patients admitted with brain abscess, not caused by head trauma or neurosurgical interventions, from two large\u2010scale hospital\u2010based databases in Japan between 2014 and 2024. We compared two treatment strategies: Strategy 1 was initiation of intravenous dexamethasone or betamethasone administration within 7\u2009days after admission and continuing for at least 3 consecutive days; Strategy 2 was no intravenous corticosteroid use throughout hospitalization. Using a clone\u2010censor\u2010weight approach, we estimated the 60\u2010day in\u2010hospital mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 627 patients met the eligibility criteria. Overall, 34 patients (5.4%) died within 60\u2009days. The estimated total effect of treatment strategy on 60\u2010day all\u2010cause in\u2010hospital death was 4.8% (95% CI, 1.1\u20139.2) for Strategy 1, and 4.6% (95% CI, 2.9\u20136.6) for Strategy 2, corresponding to a risk ratio of 1.04 (95% CI, 0.26\u20132.08) and risk difference of 0.2% (95% CI, \u22123.3 to 4.3).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>No clear difference in 60\u2010day in\u2010hospital mortality between the two treatment strategies; however, the wide confidence intervals indicate that clinically important benefit or harm could not be excluded. This study's framework may guide future studies using more granular data.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pds.70468","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T09:44:32Z","timestamp":1787910272000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Corticosteroid Use and In\u2010Hospital Mortality in Patients With Brain Abscess: A Target Trial Emulation"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7490-5820","authenticated-orcid":false,"given":"Takayuki","family":"Anno","sequence":"first","affiliation":[{"name":"Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7147-0737","authenticated-orcid":false,"given":"Toshiki","family":"Fukasawa","sequence":"additional","affiliation":[{"name":"Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7477-4071","authenticated-orcid":false,"given":"Koji","family":"Kawakami","sequence":"additional","affiliation":[{"name":"Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awac312"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0000000000000172"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2018.08.143"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0176705"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2023.08.016"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1301635"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2021.05.027"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2020.592017"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2006.01.048"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2018.04.130"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2005.07.019"},{"issue":"2","key":"e_1_2_11_13_1","first-page":"129","article-title":"Brain Abscess: Clinical Analysis of 53 Cases","volume":"36","author":"Kao P. 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